Wandering spleen as a cause of ileus

Medical Review (Med. pregled), 2025, 61(5), 47-51.

D. Dachev¹, E. Zanzov², S. Lupanov¹, P. Stefanova¹, V. Anastasova²

¹ Department of Pediatric Surgery,
² Department of Plastic Surgery, UMHAT “Sv. George” – Plovdiv
³ Department of Propedeutics of Surgical Diseases, Faculty of Medicine, Medical University – Plovdiv

Abstract. A wandering spleen is a rare anatomical abnormality in which the spleen is not in its usual location in the abdominal cavity, but elsewhere in the abdominal cavity or has a pelvic location. This anomaly has no genetic predisposition but can be congenital or acquired. The cause of splenic mobility is the absence or weakness of one or more of the ligaments of the spleen, attaching it to the left hypochondrium. A 9-yearold girl presented with abdominal pain. A few hours later, an intermittent vomiting occurred. An emergency CT scan of abdomen and lesser pelvis found twisting of the mesentery of the type of whirl sign, with the lienal artery and vein in the left abdominal half. These are traced to the structure described by ultrasonography, which has the appearance of an ectopic spleen. After a brief preoperative preparation, the child was operated on as an emergency. Wandering spleen, which is also called floating (ectopic, ptotic) spleen or splenoptosis, may be located anywhere in the abdominal or pelvic cavities, attached only by its vascular pedicle, without attachment to surrounding structures. The long pedicle makes it susceptible to twisting on itself and can cause complications. In the case we describe, torsion around the vessels was found to be 540 degrees.

Key words: ileus, wandering spleen, girl

Address for correspondence: Dimitar Dachev, MD, e-mail: Dimitar.Dachev@mu-plovdiv.bg